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Dandruff

Definition


Disease: Dandruff Dandruff
Category: Dermatological diseases

Disease Definition:

Dandruff is a common chronic scalp condition characterized by itching and peeling of the skin on the scalp. Even though dandruff is neither catching nor serious, but sometimes it could be difficult to treat and it may pose serious difficulty and embarrassment to some people. 

 

The good thing is that dandruff is controllable. Mild cases need nothing but daily shampooing with a gentle cleanser. However, medical shampoos will be needed for more severe cases.
 

Work Group:


Symptoms, Causes

Symptoms:

Symptoms of dandruff in teenagers and adults include an itchy, scaling scalp and white, oily looking flakes of dead skin that dot the hair and shoulders.

 

Cradle cap dandruff, another type, can affect babies causing scaly crusty scalp. It usually occurs in newborns but could also occur in infants. Though it might look horrifying to parents, cradle cap is not serious and usually disappears on its own by the time the baby is one year old.

 

Usually, dandruff doesn’t require medical care. However, if the person's scalp becomes red and swollen, and he/she is still scratching their head after using nonprescription dandruff shampoos for several weeks, they are recommended to see a dermatologist or a doctor. In this case, the person may have seborrheic dermatitis or another condition that resembles dandruff. By looking at the person's scalp and hair, the problem can be easily diagnosed. 
 

Causes:

There are several causes of dandruff, some of which are:

Not shampooing often enough:

The oils and skin cells build up and form dandruff if the hair isn't washed regularly.

Dry skin:

The most common cause of itchy, peeling skin is dry skin, the type that people get in winters when the air outside is cold and the rooms indoors are overheated. Generally, flakes resulting from dry skin are smaller and less oily than those from other causes of dandruff. 
 

Psoriasis:

This is a skin disorder that leads to accumulation of dead skin cells forming thick silvery scales. Psoriasis can affect a person's scalp despite the fact that it usually affects the elbows, knees and trunk. 

Irritated, oily skin (seborrheic dermatitis):

A frequent cause of dandruff characterized by red, greasy skin covered by peeling yellow or white scales is seborrheic dermatitis, which affects not only the scalp but also any area that is rich in oil glands like the eyebrows, sides of the nose, backs of the ears, breastbone, groin area, and even the armpits.

Eczema:

Someone may develop dandruff in case he/she has eczema.

A yeast-like fungus (malassezia):

Most healthy adults have malassezia living on their scalp without causing troubles. Yet, if it goes out of control feeding on the oils secreted by the hair follicles, it could irritate the skin of the scalp making more skin cells grow. After dying and falling off, the extra skin cells clump together with the oil from the person's hair and scalp making them look white, flaky, and visible on the hair or on clothes.

Overgrowing malassezia has no known reason, but some factors have an effect on the development of dandruff,  such as:

 

  • Stress
  • Illness
  • Too much oil on the scalp
  • Changes in hormones
  • A suppressed immune system
  • Not shampooing often enough
  • Extra sensitivity to the malassezia fungus
  • Neurological disorders like Parkinson's disease.

 

Sensitivity to hair care products (contact dermatitis):

If someone's scalp is sensitive to some hair care products or hair dyes, it may cause their scalp to be itchy and scaling. Using shampoos or many styling products could irritate the scalp and cause dandruff if used more frequently. 
 

Complications

Complications:

None

Treatments:

Dandruff is controllable, but its treatment needs patience and persistence. Generally, mild dandruff could be dealt with daily cleansing with a gentle conditioner to reduce oiliness and the accumulation of extra skin cells.
If usual shampooing fails, nonprescription dandruff shampoos may do the job. Not all dandruff shampoos are the same. Until someone finds the shampoo that works best for them, they may have to try more than one type.  

 

Classified according to the medication they contain, dandruff shampoos are:

Zinc pyrithione shampoos:

They contain the antibacterial and antifungal agent zinc pyrithione, making the fungus on the scalp that causes dandruff and seborrheic dermatitis disappear.

Selenium sulfide shampoos:

These shampoos slow the death of skin cells and reduce malassezia. But because they can wash away the blond, grey or any chemically colored hair, a person should be directed on how to use them correctly.

Tar-based shampoos:

Dandruff, seborrheic dermatitis and psoriasis could be treated with coal tar, a product of the coal manufacturing process that slows down the quickly dying and flaking off skin cells.

Shampoos containing salicylic acid:

Also called “scale scrubs”, these shampoos help in removing scales, leaving the scalp dry and leading to more flakes. This dryness could be relieved by using a conditioner after shampooing.

Ketoconazole shampoos:

This substance is a broad-spectrum antifungal element that works when all previous shampoos fail. The good thing is that they are available as prescription or nonprescription shampoos. They should be used daily until the dandruff is controlled and then reduced to two to three times a week. A person could alternate between two different dandruff shampoos in case one shampoo loses its effectiveness on the person's hair. In order to give time for the ingredients of the shampoo to start working, the shampoo should be left on the hair for at least five minutes. 

 

A person should see a dermatologist in case they used the shampoo regularly for more than several months and the dusting of the flakes haven't stopped. The dermatologist may prescribe a strong dandruff shampoo or a more aggressive steroid lotion.
 

Prognosis:

Not available

Expert's opinion

Expert's Name:
Certificate:
Specialty: -

Expert's opinion:

For Specialists

Clinical Trials:

Not available

 

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Consultants Corner

Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Dr. Tahsin Martini

Dr. Tahsin Martini Degree status: M.D. in Ophthalmology

Dr. Faisal Dibsi

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Dr . Dirar Abboud

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Dr. Talal Sabouni

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Samir Moussa M.D.

Samir Moussa M.D. ENT Specialist

Yaser Habrawi , F.R.C.S.Ed

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Dr. Hani Najjar

Dr. Hani Najjar Pediatrics, Neurology
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